As a promising alternative to bone marrow aspiration (BMA), mutational profiling on blood-derived circulating cell-free tumor DNA (cfDNA) is a harmless and simple technique to monitor molecular ...response and treatment resistance of patients with refractory/relapsed multiple myeloma (R/R MM). We evaluated the sensitivity and specificity of cfDNA compared to BMA CD138 positive myeloma plasma cells (PCs) in a series of 45 R/R MM patients using the 29-gene targeted panel (AmpliSeq) NGS.
,
,
,
, and
were the most frequently mutated genes. The average sensitivity and specificity of cfDNA detection were 65% and 97%, respectively. The concordance per gene between the two samples was good to excellent according to Cohen's
coefficients interpretation. An increased number of mutations detected in cfDNA were associated with a decreased overall survival. In conclusion, we demonstrated cfDNA NGS analysis feasibility and accuracy in R/R MM patients who may benefit from early phase clinical trial.
Follicular lymphoma (FL) is one of the most common lymphoma. Occasionally, FL is associated with tumoral epidural compression and management of these patients remain poorly codified. This study aims ...to report incidence, clinical characteristics, management and outcomes of patients with FL and tumoral epidural compression.
Observational, retrospective cohort study of adult patients with FL and epidural tumor compression, treated in a French Institute over the last 20 years (2000-2021).
Between 2000 and 2021, 1382 patients with FL were followed by the haematological department. Of them, 22 (1.6%) patients (16 men and 6 women) had follicular lymphoma with epidural tumor compression. At epidural tumor compression occurrence, 8/22 (36%) patients had a neurological clinical deficit (motor, sensory or sphincter function) and 14/22 (64%) had tumor pain. All patients were treated with immuno-chemotherapy; the main regimen being used was R-CHOP plus high dose IV methotrexate in 16/22 (73%) patients. Radiotherapy for tumor epidural compression was performed in 19/22 (86%) patients. With a median follow-up of 60 months (range=1-216), 5 year local tumor relapse free survival was achieved in 65% (95% CI 47-90%) of patients. The median PFS was of 36 months (95% CI 24-NA) and 5 years OS estimate was 79% (95% CI 62-100%). Two patients developed a relapse at a second epidural site.
FL with tumoral epidural compression reached 1.6% of all FL patients. Management based on immuno-chemotherapy with radiotherapy appeared to produce comparable outcomes with the general FL population.
"SIAD" oil field will be developed by CO2 flooding. CO2, a famous pollutant gas, is injected into the oil reservoir to optimize the oil recovery. This technique should be conducted economically ...according to the energy management policy in Indonesia. In general, Indonesia has two policy contracts on oil and gas: the old one is PSC-Cost-Recovery, and the new one is PSC-Gross-Split (introduced in 2017 as the new energy management plan). The contractor must choose between PSC-Cost-Recovery and PSC-Gross-Split which makes more profit. The aim of this paper is to show the best oil and gas contract policy for the contractor. The methods are calculating and comparing the economic indicators. The result of this study are (1) NPV for the PSC-Cost-Recovery is -46 MUS$, while for the PSC-Gross-Split is 73 MUS$, and (2) IRR for the PSC-Cost-Recovery is 9%, whereas for the PSC-Gross-Split is 11%. The conclusion is that the NPV and IRR for PSC-Gross-Split are greater than the NPV and IRR of PSC-Cost-Recovery, but POT in PSC-Gross-split is longer than POT in PSC-Cost-Recovery. Thus, in this case, the new energy policy contract can be applied for CO2 flooding technology since it yields higher economic indicators than its antecendent.
Highlights • 30% of patients with t-MDS/AML have a concomitant active neoplastic disorder (CAND). • 5-Azacytidine (AZA) treatment is feasible for t-MDS/AML patients with CAND. • Active neoplastic ...treatment in association with AZA is feasible. • Response rate and OS are similar between t-MDS/AML with or without CAND. • OS of these patients is 12.7 months compared to 0.62 months for untreated patients.
Un diagnostic qui aura pris du temps Danu, A.; Chalumeau, L.; Ribrag, V. ...
La revue de medecine interne,
January 2013, 2013, 2013-1-00, Letnik:
34, Številka:
1
Journal Article
Essentials Risk factors of bleeding in adult immune thrombocytopenia are not known. This multicenter study assessed risk factors of bleeding at immune thrombocytopenia onset. Platelet count ...thresholds associated with bleeding were < 20 × 10
L
and < 10 × 10
L
. Exposure to anticoagulants was a major risk factor of severe bleeding.
Background The aim of this cross-sectional study was to assess risk factors for bleeding in immune thrombocytopenia (ITP) adults, including the determination of platelet count thresholds. Methods We selected all newly diagnosed ITP adults included in the Cytopénies Auto-immunes Registre Midi-PyrénéEN (CARMEN) register and at the French referral center for autoimmune cytopenias. The frequencies of any bleeding, mucosal bleeding and severe bleeding (gastrointestinal, intracranial, or macroscopic hematuria) at ITP onset were assessed. Platelet count thresholds were assessed by the use of receiver operating characteristic curves. All potential risk factors were included in logistic regression models. Results Among the 302 patients, the frequencies of any, mucosal and severe bleeding were 57.9%, 30.1%, and 6.6%, respectively. The best discriminant threshold of platelet count for any bleeding was 20 × 10
L
. In multivariate analysis, factors associated with any bleeding were platelet count (< 10 × 10
L
versus ≥ 20 × 10
L
, odds ratio OR 48.2, 95% confidence interval CI 20.0-116.3; between 10 × 10
L
and 19 × 10
L
versus ≥ 20 × 10
L
, OR 5.2, 95% CI 2.3-11.6), female sex (OR 2.6, 95% CI 1.3-5.0), and exposure to non-steroidal anti-inflammatory drugs (NSAIDs) (OR 4.8, 95% CI 1.1-20.7). A low platelet count was also the main risk factor for mucosal bleeding. Exposure to anticoagulant drugs was associated with severe bleeding (OR 4.3, 95% CI 1.3-14.1). Conclusions Platelet counts of < 20 × 10
L
and < 10 × 10
L
were thresholds for major increased risks of any and mucosal bleeding. Platelet count, female sex and exposure to NSAIDs should be considered for assessment of the risk of any bleeding. Exposure to anticoagulant drugs was a major risk factor for severe bleeding.
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